By Steve Moran

The NIC 2024 spring conference is now history. My overarching impression is that we as an industry are still trying to figure out what is important to us, to society, and to the industry — and that we have a long way to go to figure it out. I will get to that in a minute, but some quick bullet points:

  • Attendance was clearly down. I don’t know the exact numbers, but it was clear that was the case. In talking to people, the sense was that with interest rates so high, there are fewer deals being done.
  • Senior living leaders are by nature amazingly optimistic, perhaps at times even bafflingly optimistic. It was not that people were pessimistic — not even close — but it felt like one of the most pragmatic senior living conferences I have ever attended, in the best possible way: a better but more realistic appreciation of the important role our industry plays in the lives of older people and the health care system. A better recognition that we still have some work to do in figuring out what senior living needs to look like for the next generation.
  • There was very little talk about tech, except in the area of data. There is an understanding that data is important but that we have a ways to go with respect to figuring out how to leverage it.
  • There was very little talk about staffing and occupancy challenges. This is not to say the problems have been solved, because, while better, they persist. It was more along the lines of that being old news, nothing more to say about it.
  • There is a growing gap between successful and not so successful operators. I have been seeing this for at least a year. There are operators who are crushing it. High occupancy, good to great margins, and others that are barely hanging in there … (and some that are not making it). That divide is more apparent and growing bigger.

The Big Frustration

The biggest, most important content session was an interview of Meena Sechamani, the head of Medicare and Medicaid, by David Grabowski from Harvard Medical School, who is a huge voice in the world of aging policy.

For the first time, at least publicly, CMS is paying attention to senior living and more importantly engaging in dialog with senior living leaders.

I was completely pumped up about this session, getting there 30 minutes early to grab my front row seat, only to discover that when the presentation started, the room was not even half full. It was baffling and discouraging.

The lack of attendance suggests that mostly the industry is missing the huge potential to be a significant part of the health care system in this country. Sechamani controls an annual budget that is the size of a number of countries’ GDPs. More of that money could and should be flowing to senior living, and not just the nursing home sector. But it is hard to imagine CMS taking us seriously if the industry is that indifferent.

I am fearful that this was a big miss on the part of the industry, and I worry that too many senior living leaders simply don’t really see the opportunity that is right in front of them.

I am an eternal optimist about our industry and its ability to transform the lives of older people and the lives of those who work in senior living, but it is entirely possible that many of the current generation of owners and operators will be so committed to the old way of doing things (the current way of doing things) that we will find health care systems giving up on operators that exist today and becoming senior living operators in their own right.

The opportunity is huge, but so is the risk.